Multiple Sclerosis
An autoimmune disorder occurs when the body's immune system attacks its own tissues or cells. It is not known what causes this reaction, but it is thought that some cases are triggered by viral or bacterial infection. Multiple sclerosis, or MS, is an autoimmune disorder involving myelin, the protective covering around nerve fibers in the brain and spinal cord (or central nervous system). In particular, multiple sclerosis develops when the immune system mistakenly treats myelin as a foreign substance. White blood cells then attack and destroy patches of myelin, interrupting critical nerve impulses to and from the brain. The name, multiple sclerosis, refers to the patches of hardened scar tissue, or sclerosis, which form where myelin has been destroyed.
According to the National Multiple Sclerosis Society, an estimated one-third of a million Americans live with MS and nearly 200 new cases are diagnosed each week. People with MS suffer a variety of symptoms due to problem with their central nervous system. These problems include blurred vision, slurred speech, loss of bladder and bowel control, problems with sexual function, generalized weakness and severe depression. Among the more debilitating symptoms are numbness, loss of coordination or balance, painful muscle spasms and tremors, and loss of movement control or paralysis. The particular symptoms that each MS patient endures relate to the location of the nerve damage and can occur nearly anywhere in the body.
MS affects individuals differently. It is without consistent pattern and can resemble other disorders of the central nervous system. There are, however, three general patterns of MS: relapsing remitting, secondary-progressive, and chronic-progressive.
Relapsing-remitting MS is probably the most common pattern. It is characterized by unpredictable attacks or relapses, followed by periods of quiescence or remission. In remission, a patient's health may return to its original state for up to several years. Secondary-progressive MS is much like relapsing-remitting, except the patient's overall condition usually deteriorates further with each attack. Physical, mental or emotional stress may trigger a relapse. Chronic-progressive MS is the most severe pattern, in which the patient's condition steadily worsens without attacks or remissions, and results in partial or total disability. Finally, there is a fourth, benign, category for which most patients are never even diagnosed, as they will experience only minor symptoms once or
twice in their lifetime.
Sadly there is no known cure for multiple sclerosis. Patients are treated medically for their symptoms. Prednisone is a cortisone type of steroid hormone, and adrenocorticotropic hormone (ACTH) is a hormone that stimulates the body to produce its own cortisone. Thus, ACTH acts like cortisone when administered to treat MS. These powerful hormones are used to shut down the immune system during acute attacks. Common side effects include nausea and vomiting, mood swings, depression, sleeplessness, fluid retention, with bloating and drastic weight gain. Long term cortisone use can also cause diabetes, cataracts, stomach problems, abnormal blood potassium levels, immune system breakdown, thinning of the bones (osteoporosis), redistribution of body fat which may change facial appearance, muscle atrophy, and countless other problems. Additional medications with their own unique side effects are often required to treat the complications of long term cortisone use.
Over the past few years, nonsteroid drugs, such as Avonex, Betaseron and Copaxone, have become increasingly more popular in the treatment of multiple sclerosis. However, because they are fairly new, much about their activities in the body remains unknown.
Betaseron and Avonex are interferons that are proteins thought to help regulate the body's immune response against myelin. Adverse reactions include tissue loss at the injection site, flu-like symptoms, menstrual problems and depression. Betaseron comes with a warning from its distributor that mental disorders have been observed inpatients who have used it. During a three year study involving 372 patients, one suicide and four attempted suicides occurred. Although Avonex is reportedly easier to tolerate, it commonly causes flu-like symptoms, muscle aches, fever and chills. Copaxone is a non-interferon drug, also thought to block myelin-specific autoimmune responses. Its side effects include adverse tissue reactions at the injection site, chest pain, flushing, nausea, anxiety, weakness and painful joints. Reactions to all of these treatments are said to decrease over time but, for some patients, this has not been the case. The average cost of each of these medications is currently about $1,200 a month.
To combat the painful muscle spasms many MS patients suffer, the FDA has approved dantroline (Dantrium) and baclofen (Lioresal). Both are toxic substances that often cause serious side effects. Many patients complain that they are generally ineffective in controlling muscle spasms. Doctors routinely prescribe tranquilizers, muscle relaxants and sedatives for muscle spasms. These drugs sometimes help control spasms but often leave patients in debilitated, dysfunctional states. These drugs are sometimes associated with hallucinations, and some patients have reported symptoms of withdrawal when discontinuing their use.
Today a growing number of patients with multiple sclerosis who are discouraged by the lack of results from standard MS treatments are turning to marijuana as a sensible alternative. Many say marijuana gives them relief without the dangers and unwelcome side effects of steroids, tranquilizers, muscle relaxants or sedatives. They claim that marijuana is especially helpful in reducing their painful muscle spasms and tremors, and in regaining their muscle coordination and control. From their experience with long term use, some MS patients believe that marijuana actually slows down the progression of their disease. They push aside the standard drugs that may make them feel worse and use marijuana in therapeutic doses that they feel are safer and more effective.
In clinical tests, synthetic THC has decreased the severity of muscle spasms associated with multiple sclerosis. Many MS patients use synthetic THC, or Marinol, even though their doctors cannot legally prescribe it, because it provides more relief than other pharmaceuticals. However, Marinol's therapeutic effects occasionally diminish as patients develop a tolerance to it. This tolerance does not seem to occur with marijuana.
Another drawback of Marinol is the difficulty in achieving the right dose. Another may be that THC, in the absence of the compounds found in marijuana smoke, is not sufficient for treating spasticity. Researchers believe that cannabidiol, one of the other 460 known compounds found in marijuana, may work more effectively than THC. Animal studies have shown that THC in high doses can actually excite the muscles. Cannabidiol is thought to counteract this effect.
More research on the compounds found in marijuana would provide a better understanding of just how marijuana can aid the treatment of multiple sclerosis. Generally it is used for treating spasticity and pain. However, there are many different symptoms that afflict people with MS, and there may be other ways in which marijuana is therapeutic.
Another potential use of marijuana, not yet thoroughly explored, is in the treatment of ataxia, which is the loss of muscle coordination. This possibility offers hope to MS patients who are debilitated by ataxia. In the last ten years, a few small clinical studies probing the effect of marijuana on ataxia have been published in neurology journals. More recently, receptor cites for marijuana have been discovered in areas of the brain that control memory, cognition, pain, nausea, and motor coordination. This finding supports the notion that marijuana may somehow facilitate transmission of nerve impulses from the brain to the muscles to improve symptoms in MS.
There are claims that marijuana not only relieves the symptoms of multiple sclerosis, but also treats the progression of the disease itself. Some scientists believe that marijuana has potential to both enhance and suppress immune responses. Though its suppressing tendencies are thought to be mild, they are of concern to doctors in the treatment of AIDS. For treating an autoimmune disease like MS, on the other hand, researchers see promising possibilities.
Science
Reports that MS patients were successfully using marijuana to treat their symptoms prompted research on synthetic THC in the late 1970s.
